The Re-emergence of Thallium as a

Heavy Metal Contaminant of Human Populations

Michael Rosenbaum, MD, and Ernest Hubbard

Based on an interview with Nancy Faass, MSW, MPH

Thallium is a heavy metal with toxic effects so significant, it was banned for use in American consumer products in 1972, more than two decades before lead was prohibited in gasoline. The toxicity of thallium rivals that of mercury and lead, and the three metals appear consecutively on the periodic table: mercury, atomic number 80; thallium, 81; and lead, 82. Thallium is absorbed readily in all tissues of the body. It can be inhaled, it is absorbed directly through the skin on contact, and it can be consumed in food or liquids. Once thallium is absorbed, it dissolves quickly in liquids and disperses readily into every cell in the body, one of the reasons it is so exceptionally toxic.¹

Our work in two pilot studies identified the presence of elevated levels of thallium in patient populations, which led to a third pilot project, documenting thallium in the present-day food chain, in cruciferous vegetables such as kale.

Pilot Study 1

EH: The inception of this story dates back to the year 2010. At the Preventative Medical Center of Marin (PMC), we had been asked to test an oral chelation product, a naturally derived detoxification compound made from zeolite by a company out of Cleveland

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Life Health Science. They contacted Elson Haas, MD, the Medical Director of PMC, and in a series of conversations asked if he would conduct an independent study of this compound as it related to the removal of toxic heavy metals. My subsequent role involved experimental design, recruitment and coordination of study participants, management and execution of testing and protocols, analysis of lab reports, and reporting of findings. We designed an experiment that was immediately admitted as a pilot study involving 40 people, and the company paid us to perform the research. They provided the chelating agent, and we began submitting lab samples to Doctor’s Data, a medical laboratory that Elson had utilized for more than two decades for this type of testing. We found that there was an efficacious response in terms of the removal of certain heavy metals; most notably mercury and lead.

Pilot Study 2

EH: At that time, the company was further refining the chelating product. As the project proceeded they offered us the newer version of the product and asked if we would like to continue with a second phase of the study. Dr. Haas was busy, so Dr. Michael Rosenbaum served as principle investigator on the next phase of the project, which involved setting up another pilot study to test whether or not we found duplication of results, and whether the newer compound was more efficacious. Consequently, we enrolled 10 people from the initial study to provide comparative data and 10 new participants. The data from the two studies provided us a total sample size of 50, which is large enough to be analyzed for statistical significance.

During the second phase of that work I noticed high levels of thallium in a number of the lab reports, and Michael Rosenbaum and I began tracking the thallium levels. We noticed that people who were exhibiting high thallium had high thallium in their second lab reports as well. We also noticed that patients with high thallium on the lab results had thallium-related symptoms. One patient, for example, had severe arrhythmia (which later subsided when she stopped eating kale). This raised the question of whether the new, improved version of the chelating product, Orea, is more effectively chelating out thallium, elevating the levels of thallium detected in patients’ urine samples. The new product is more highly purified, and has been verified in third-party evaluations in terms of molecular weight, charge profile, and molecular size and is said to be capable of traversing the blood brain barrier.

In retrospect, when I went back and reviewed the results of the first study, there were fairly high thallium levels in that initial study, but compared with the mercury and lead, they did not capture my attention. When I saw thallium emerging as a relatively high toxic metal, reported with frequency in the second study, I started wondering what other issues were involved. Michael and I talked about this a great deal.

Clinical Presentation

Chronic Thallium Exposure

Note: Signs and symptoms of toxicity due to chronic exposure to thallium include fatigue, headaches, depression, hallucinations, psychosis, dementia, poor appetite, leg pain, hair loss, and/or disturbances of vision. Chronic thallium poisoning can occur over a period of months or years, due to absorption through the skin, respiratory tract, or gastrointestinal tract, accumulating to toxic levels. The presentation of chronic thallium toxicity is similar to that of numerous other diseases; consequently, many cases of industrial, environmental, and domestic thallium exposure probably go undetected.²

Symptoms of Acute Exposure

MR: We know something about acute exposure because Saddam Hussein put thallium in bread and in birthday cakes and fed it to large numbers of people. They all experienced clinically similar outcomes.³ The first day involves primarily gastro-intestinal symptoms: nausea, vomiting, and severe abdominal pain. From about day 2 to day 5, thallium primarily affects the nervous system. That begins with ascending neuropathy, starting in the feet and moving up the legs and the thighs. People can experience numbness, tingling, shooting pains, and/or burning sensations in the skin, which can traverse all the way up the body. If the symptoms progress and become more serious, there is a lack of coordination, and ataxia is very common. Of all the heavy metals, thallium is the one that produces ataxia more frequently than any other. People can also develop tremors and seizures, so these are definitely aspects of the clinical picture.⁴

EH: Arrhythmias may be detected even in the absence of physical tremors.

Physiologic Activity

MR: In addition to effects on the brain, and nervous system, thallium is know to have significant effects on the liver, kidneys, and heart. Approximately 50% of the thallium that goes to the kidney is reabsorbed right back into the kidney rather than being discharged in the urine. That is one of the reasons it takes so long for the body to get rid of this toxin. One of the organs that is most affected by thallium is, therefore, the kidney because the concentration of thallium in the kidney is very high, perhaps five times higher than it is in most other organs.

EH: There is a reverse feedback loop here: the more thallium the body accumulates, the less able it is to rid itself of thallium. So the kidney begins to malfunction, the glutathione detoxification system stops working. The tendency for thallium to stack up in the body increases with every day that goes by, if the source of the exposure is not terminated.

MR: A journal article published in Europe in 2009 reports that thallium bio-accumulates in the body.⁵ Thallium binds so tenaciously to sulfur that it persists in hair and in tissue in the body that contains sulfur, released into the body very gradually. In the process of detoxification, toxins are sent to the liver, on to the gall bladder, and on to the small intestine, but 50% of the thallium is reabsorbed right back into the body through the process of enterohepatic recirculation.

Mechanisms of Action

Adverse Effects on Myelin

MR: Thallium is highly toxic to the entire nervous system and more so to that system than perhaps any other system in the body. It upsets the production of myelin, which is responsible for the speed with which nerve impulses are conducted. When myelin is destroyed, that results in lesions that can resemble multiple sclerosis. Thallium de-myelinates nerves and therefore, slows down nerve conduction, in some cases causing symptoms that look like optic nerve neuritis.

EH: From the standpoint of the biochemistry, thallium’s atoms, molecules, and ions function like a Jekyll and Hyde phenomena. Myelin contains both cysteine and methionine, which enable the myelin sheath to retain its structure. It doesn’t take much of a breakdown in the myelin sheath to trigger cross firing. In other systems of the body, 10% loss is less of an impairment. You could lose 10% of a muscle and simply feel fatigued. Even 10% of your hair could fall out, and you might not notice it that day. However, with the nervous system, petit mal, grand mal, arrhythmias, tremors, ataxia, these are symptoms could be triggered in the early stages of myelin degeneration.

MR: The myelin degeneration is consistent with thallium’s mechanism of action with respect to sulfur and sulfur-containing bonds, and interference with sulfur metabolism.

Compromised Sulfur Metabolism

MR: Many heavy metals bind to sulfur. Mercury binds to sulfur. Thallium binds tenaciously to both disulfide bonds, which are sulfur-sulfur bonds, and to mercaptans, sulfur-hydrogen bonds. Glutathione contains a mercaptan. Thallium interferes with the synthesis and production of glutathione, which is considered the most important antioxidant in the body. When glutathione is reduced, there is less ability to fight infection, and immune response is diminished. Glutathione is the key detoxifier, and among all the antioxidants, it detoxifies heavy metals. Thallium manages to destroy its nemesis, the very substance that could eliminate the thallium.

Clinically, thallium manifests in the body in hair, nails, and skin—keratin: the protein keratin contains mostly disulfide bonds. When thallium binds to these disulfide bonds they begin to unravel, and their ability to bind to each other becomes disrupted.

EH: Thallium compromises the ability to maintain protein structure and function. To the extent that enzyme function is in direct relationship to the integrity of its structure, enzymes cease to function, and structural proteins lose their ability to function correctly.

MR: The conformation of the proteins is changed. People experience thinning hair and hair loss. That may be one of the first things that people notice and indeed, we have found a few patients who had hair loss that directly correlated with their thallium exposure.

Interruption of Potassium Metabolism

MR: Thallium mimics the structure of potassium. When thallium is expelled in coal-ash, for example, and released into the atmosphere, the thallium content converts into various salts, so it no longer exists as pure organic thallium. It exists as thallium oxide, thallium hydroxide, thallium sulphides, or thallium sulphate, in these ionic forms.⁶ The size of the atom of the ion of thallium almost perfectly simulates the size of the atom in the potassium ion. Consequently the body is completely misled, responding as if the thallium were potassium. Thallium, therefore, has the ability to enter into all the metabolic processes that involve potassium. The major biochemical effect of potassium is that it is pumped inside cells, sequestered inside cells, and it exchanges with sodium in order to produce electrical discharges. That is how nerves function.

NF: What about ATP, also?

MR: In substituting for potassium, thallium interferes with the major enzyme in the human body, sodium potassium—ATPase. Although there are over 600 enzymes in the human body, ATPase is so important that it uses about 25% of the total energy in the body. This is especially true in the systems that have high utilization such as the nervous system. Consequently, interference with that enzyme’s electrical transmissions through nerves has an impact on all the functions that nerves perform—on sensation, on motor ability, movement, coordination, and cognition (both the ability to think and to remember). All of these functions are at risk.

EH: There is an interesting aspect of the physics here. If you take a very heavy atom that has a strong attraction for electrons, for example thallium, and you compare it with potassium, it becomes apparent that potassium is lighter and has far fewer protons and neutrons in the nucleus. Looking at the atomic diameters of those two atoms when they are fully loaded with electrons, they appear to be quite different. The thallium atom has an electron in its outermost shell that is quite some distance relative to potassium. But when you strip that electron away, it’s like taking Pluto out of the solar system. All of a sudden, the size of the remaining ion is so close in diameter to that of potassium, the cell has no way of knowing what it is looking at. It is looking at Dr. Jekyll and doesn’t realize that five times the weight of that potassium atom is about to descend on a molecular process in the form of Mr. Hyde. Imagine Dr. Jekyll and Mr. Hyde driving a Ferrari—that’s the image.

Compromised Protein Production

MR: One other aspect of the clinical story that we have not discussed involves protein. Thallium exists ionically in two forms—thallium +1 and thallium +3. As thallium +1, the thallium ion mimics potassium. Thallium +3 has the ability to bind to the ribosome of the cell where messenger RNA binds amino acids together to create proteins. Thallium +3 interferes with that process directly. Therefore, it sabotages the production of new proteins, which are used for healing, to make antibodies, to create neurotransmitters.

EH: If you think about nausea as one of the early symptoms, and consider the role of digestive enzymes and of the nervous system in good digestion, those two processes alone could explain some of the dramatic effects of thallium. Ribosomes produce digestive enzymes when food is being consumed. If that process is broken down, there is no normal digestion, and there is no normal peristalsis. No wonder people get nauseous. This is one bad atom.

Testing and Clinical Interventions

Clinical Screening

I encourage anyone who is working with patients to put this right on the front of their radar, because there are a great many symptoms being ascribed to other causes that, in fact, may correlate with exposure to thallium or other toxic metals. You will want to put testing in place so that it is available, and it is as affordable as possible. We use a simple questionnaire to determine if patients are a candidate for heavy metal toxicity testing.

Talking Points in Screening Patients

• Are you experiencing symptoms for which there are no other logical explanations?

• Are you exhibiting symptoms of heavy metal toxicity?

• Have you experienced a possible exposure; for example, do you live near a power plant or a refinery? What are your 10 most frequently consumed foods?

• Have you had a toxic heavy metals test in the last 2 or 3 years?

Differential Diagnosis

EH: Metals, including thallium, are important to rule out because of the ubiquitous toxic effects that occur across every major system in the body, including the brain and nervous system. If you have patients with any of the following symptoms, heavy metals testing will be absolutely essential to a good differential diagnosis.

Testing

MR: To date, the gold standard in laboratory evaluation is a 24-hour urine collection, with provocation. The provocation agents (EDTA and DMSA) that work well for lead, mercury, and cadmium do not work for thallium. Although, provocation does not appear to be necessary, our testing found that the zeolite supplement Orea appears to increase thallium excretion. The normal range is considered to be below 5 mcg/liter/24 hr, although different reference ranges are sometimes seen. Of all the integrative labs, I think Doctor’s Data is best suited to this test. However, even Quest and LabCorp can perform it and may send the sample to a reference lab.

Hair analysis is used less frequently because the quantitative relationship between exposures, internal levels, and relative concentrations has not been clearly established. “Among poisoning victims, hair concentrations range from 48 ppb to 35,000 ppb with most between 150 and 1500 ppb…With regard to timing, elevated thallium concentrations have been found in hair as early as 2–3 weeks after ingestion in poisonings and as late as 13 months after the cessation of…occupational exposures.”⁸

Treatment

MR: The most effective approach to removing thallium from the body is utilizing a substance called “Prussian blue.”⁹ Prussian blue contains a potassium ion that is replaceable. Thallium displaces the potassium from the Prussian blue, and it occupies the Prussian blue instead. That is how the body gets rid of it.¹⁰ For some reason, the same treatments that typically are used for lead and mercury may not work for thallium. For instance, I often use DMSA to treat mercury poisoning. I use it for lead poisoning. It does not work for thallium. In fact, if you look at the literature, they say that aside from Prussian blue we do not know of much of anything else that really does work. Activated charcoal also helps, and now we know that Orea, a form of zeolite, is helpful. There is also evidence that chlorella bids thallium. It is harder for a clinician to detoxify thallium than it is to detoxify any other heavy metal known.

Prussian blue is a crystal blue lattice of potassium ferric ferrocyanide that exchanges potassium ions from its lattice with thallium ions in the gut lumen, interrupting enterohepatic recirculation. The Prussian blue releases a negligible amount of cyanide (< 1.6 mg), the minimal lethal dose of cyanide in humans is indicated to be approximately 50 mg.¹¹

Thallium in the Food Chain: Connecting the Dots

EH: On July 3^rd of 2014 in an otherwise random internet search on what might be the source of the thallium, I stumbled across a Czechoslovakian paper from 2006: “Uptake of Thallium from Artificially Contaminated Soils by Kale.”¹² In our attempts to identify the source of the thallium we had ruled out cement manufacturing in Marin County, petroleum distillation, coal-powered plants, and fire-generated electrical plants.

MR: In this Czechoslovakian article they stated directly in the abstract, “It can be concluded that the ability of some plants of the brassica family that are planted as common vegetables to accumulate thallium is very high and can be a serious danger for food chains.”¹³

NF: This seems hugely important because currently the green drink du jour is that kale-based green drink…

MR: Kale has become the icon of the green movement.

EH: I had studied enough and talked to Michael enough about the symptom progression and the symptom profile to know that there was a high correlation between the clinical presentation of some of the study participants and high levels of thallium. When the dots got connected to the possibility that it was coming from kale consumption, I emailed everyone in the study with a blinded survey.

Correlating Exposure and Symptoms

EH: When we surveyed participants, we simply asked them to list their top ten favorite vegetables, whether they were organic or not, and approximately how much they ate. People with very low levels of thallium did not eat a lot of crucifers, if any, and people with very high urine thallium were eating kale, cabbage, and broccoli three to ten times a week. There was a fairly strong correlation. So I immediately sat down with Michael, and we began designing the next phase of the study. Within a month Michael and I knew we were onto something.

When we were realized that there was a strong correlation between high thallium in the urine, high kale consumption, and thallium-like symptoms, the very first thing that we did was discuss with each of the people who were exhibiting high thallium and eating a lot of crucifers whether or not they would be willing to change their diet, and they were. They also continued taking Orea. We noticed within 60 to 90 days a substantial decline, especially in the case of three people who had all showed significant symptoms and thallium in their urine.

Pilot Study 3

EH: Based on this information, we designed our third pilot study, submitting 121 samples of various foods for testing by two different laboratories for the presence of thallium and other metals.¹⁴ This led to the identification of thallium in the present-day food chain, in approximately 20% of samples, and notably in cruciferous vegetables such as kale.

Outreach

EH: Over the course of the past year, we personally reached out to the local organic community, to growers, and retailers. However, in terms of interviews and publishing, we sat on this data for a year, because we wanted to be sure that this information was going to get out to the public in a productive and conscientious way. On July 7, 2015 an article entitled Vegetable Detectives was published on a blog that serves about 150,000 readers (see www.Craftsmanship.com). Since then, the issue has been featured on Salon.com, Huffington Post, at least 10 other blogs, and on the Dr. Oz show (in a segment aired on 10/09/15).

As an interesting update, once our research went public I started receiving calls from people all over the world who had high thallium, from as far away as Tel Aviv and Ireland. I have been Skyping with them and they are showing me their Doctor’s Data thallium reports, saying: “Everybody I’ve been to has put me on a super food-juice diet.” I have suggested that they stop their exposure, and I’ve gotten emails from them indicating that they are actually starting to feel better.

Conclusion

EH: In these pilot projects, we were able to demonstrate on a small scale that both thallium in the urine and symptoms started to abate with a reduction in the intake of cruciferous veggies. This is an important finding, because if patients continue to replenish the source of the thallium every day with kale green drinks or stir-fried vegetables, even the best chelation of thallium is going to be hampered by a continual replenishment.

A second article will be published in a forthcoming issue of Townsend Letter with additional (and surprising) information on potential sources of thallium in the food chain, including organic baby food, and updates on (equally surprising) responses from the organic food industry.

Financial Disclosure

The company that produces Orea, the chelating agent, was a financial contributor to the first study, but was not a financial contributor in any way to the second pilot study or the third study, which consisted of vegetable assays. Michael and I did this on our own time and our own money, to buy the equipment and to gear up to obtain and prepare the samples for the labs. We paid thousands of dollars for heavy metal assays on vegetable samples. The company that produces Orea was not involved in the third study in any way, so there has been no conflict of interest.

Michael Rosenbaum, MD

Dr. Rosenbaum holds a medical degree from Albert Einstein College of Medicine in New York, and a master’s degree in biochemistry and metabolic medicine from Hebrew University in Jerusalem, with residence in psychiatry at UCSF and certification in medical acupuncture. His practice, located in the San Francisco Bay Area, emphasizes clinical nutrition, environmental medicine, allergy and immunology, antiaging medicine, and the treatment of chronic health conditions such as Lyme disease. Within integrative medicine, he has served as President and Vice President of the Orthomolecular Medical Society (OMS); editor of the Society’s journal; Director and Vice President of the Orthomolecular Health Medicine Organization (OHM); and President and Board member for The Healthy Foundation. Additionally, Dr. Rosenbaum is the author of two successful books, SuperSupplements, and Solving the Puzzle of Chronic Fatigue. Syndrome.

Preventive Medical Center of Marin

4340 Redwood Highway, Suite A-22

San Rafael, CA 94903

Phone: 415.927.9450

Email: info@DrMichaelRosenbaum.com

Website: www.DrMichaelRosenbaum.com

E. Hubbard

Hubbard’s academic background includes a Bachelor of Science in genetics/biochemistry from Oregon State University and two years of work toward a PhD in molecular biology and developmental genetics at the University of Minnesota. He has more than three decades of hands-on scientific experience, including research manager of multi-million dollar programs with major corporations such as Eli Lilly and Mitsubishi. He was co-founder and VP of research at Sungene Technologies Corp., and CEO of BioSource Technologies Corp. Within the field of organics, Hubbard has been consultant to a number of food companies and was founder and manager of PureHarvest Corp, a company that developed patented technology for growing crops such as rice without the use of herbicides and pesticides. Within integrative healthcare, he has conducted more than 10 years of research in the field of human aging, and he has served as a health coach to several thousand people.

Email: ErnieHubbard@yahoo.com

Phone: 415.215.8933

Website: www.TheSageCenter.org

Resources

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Editorial: Nancy Faass, MSW, MPH

Working collaboratively with clients, Ms. Faass has been active in the development, research, writing, and editing of more than 45 books on functional and integrative medicine by publishers that include Elsevier, Harper, McGraw-Hill, and a dozen other imprints. Director of Writers’ Group Inc. for the past 20 years, she also develops articles, white papers, lab manuals, blogs, and Web content. To obtain a 20-minute phone consult at no charge, email info@HealthWritersGroup.com, or call 415.922.6234

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